Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewGonadotropin releasing hormone agonist protocols for pituitary desensitization in in vitro fertilization and gamete intrafallopian transfer cycles.
Gonadotropin releasing hormone agonists (GnRHa) are used in assisted reproduction cycles to reversibly block pituitary function and prevent a luteinizing hormone surge. In the short and ultrashort protocols of GnRHa administration, injection of gonadotropins is commenced a few days after the start of GnRHa. In the long protocols (with GnRHa started either in the midluteal phase or in the early follicular phase) gonadotropin administration is delayed until pituitary desensitization has been achieved, usually 2-3 weeks. ⋯ On the basis of clinical pregnancy rate per cycle started, this meta-analysis demonstrates the superiority of the long protocol over the short and ultrashort protocols for GnRHa use in IVF and GIFT cycles.
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Patients with isolated supratentorial brain tumours, presumed to be primary on imaging, have two surgical management options - biopsy or resection. Surgical opinions appear to be equally divided when considering the relative risks and benefits of these two procedures. ⋯ Given that no qualifying studies were identified and because this is an important issue, both in terms of patient risk and benefit and health economics, the author feels it important to conduct a randomised controlled trial in this subject.
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Neisseria gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth and can cause gonococcal opthalmia neonatorum. ⋯ Any of the antibiotic regimens tested in these trials appear to be effective for the treatment of gonorrhoea in pregnancy in terms of their effect on microbiological cure. For women who are allergic to penicillin, this review provides reassurance that treatment with ceftriaxone or spectinomycin appears to be at least as equally effective in producing microbiological cure.
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To assess the effects of providing pregnant women with isocaloric protein supplements (ie where the protein replaces an equal quantity of nonprotein energy) on gestational weight gain and on the outcome of pregnancy. ⋯ Balanced protein supplementation alone (ie without energy supplementation) is unlikely to be of benefit to pregnant women or their infants.
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In many settings, symphysis-fundal height measurement has replaced clinical assessment of fetal size by abdominal palpation because the latter has been reported to perform poorly. ⋯ There is not enough evidence to evaluate the use of symphysis-fundal height measurements during antenatal care.